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Breastfeeding Initiation and Duration: A 1990-2000 Literature Review
Open accessAbstract
Objective To review the literature on breastfeeding initiation and duration and to delineate effective strategies for promoting positive breastfeeding behaviors.Data sources Computerized searches on MEDLINE, CINAHL, and the Cochrane Library.Study selection Articles from indexed journals relevant to the objective and published after 1990 (except for classic findings) were reviewed. Although a myriad of pertinent articles was located, referenced citations were limited to three per point. When article selection was required for a specific point, preferences were given to (a) randomized controlled trials; (b) meta-analyses; (c) studies with the largest, most representative samples; and (d) investigations conducted in North America.Data extraction Data were extracted and organized under the following headings: benefits of breastfeeding, breastfeeding initiation and duration, personal characteristics, attitudinal and intrapersonal characteristics, hospital policies and intrapartum experience, sources of support, breastfeeding interventions, and review implications.Data synthesis Although the health benefits of breastfeeding are well documented and initiation rates have increased over the past 20 years, most mothers wean before the recommended 6-months postpartum because of perceived difficulties with breastfeeding rather than due to maternal choice. Women least likely to breastfeed are those who are young, have a low income, belong to an ethnic minority, are unsupported, are employed full-time, decided to breastfeed during or late in pregnancy, have negative attitudes toward breastfeeding, and have low confidence in their ability to breastfeed. Support from the mother's partner or a nonprofessional greatly increases the likelihood of positive breastfeeding behaviors. Health care professionals can be a negative source of support if their lack of knowledge results in inaccurate or inconsistent advice. Furthermore, a number of hospital routines are potentially detrimental to breastfeeding. Although professional interventions that enhance the usual care mothers receive increase breastfeeding duration to 2 months, these supportive strategies have limited long-term effects. Peer support interventions also promote positive breastfeeding behaviors and should be considered.Conclusions A promising intervention is the complementation of professional services with peer support from a mother experienced in breastfeeding. This lay support appears to be an effective intervention with socially disadvantaged women.
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“Research suggests a relation between breastfeeding and depressive symptoms [51-55].”
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Self-citation
Metadata
- Authors
- Dennis, C.-L.
- Affiliations
- University of Toronto (CA)
- Corresponding author
- Dennis, Cindy-Lee
- ORCID
- Dennis, Cindy-Lee
- Venue
- Journal of Obstetric, Gynecologic & Neonatal Nursing
- Publisher
- Elsevier BV
- Published
- 2002-01
- Volume
- 31
- Issue
- 1
- Pages
- 12-32
- ISSN
- 0090-0311 (ISSN-L)
- 0884-2175
- OpenAlex
- W2081239906
- Cited by
- 713
- References
- 188
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 17 · 2023: 19 · 2022: 20 · 2021: 42 · 2020: 27 · 2019: 43 · 2018: 43 · 2017: 38 · 2016: 32 · 2015: 42 · 2014: 48 · 2013: 45 · 2012: 49
- FWCI
- 2.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Obstetric, Gynecologic & Neonatal Nursing (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- breastfeeding initiation, breastfeeding duration, breastfeeding promotion, breastfeeding interventions, peer support, breastfeeding attitudes, maternal confidence, hospital policy, maternal employment, socioeconomic status, ethnic minority mothers, weaning
- MeSH terms
- Breast Feeding, Female, Health Promotion, Humans, Peer Group, Health Behavior, Randomized Controlled Trials as Topic, Maternal-Child Nursing
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